Treatment options for prostate cancer now range from active monitoring, radiotherapy with or without adjuvant endocrine therapy, to prostatectomy and palliative care. However, there are certain concomitant circumstances that influence the quality of life with every therapy. What do patients pay particular attention to during treatment?
A patient-oriented study from Denmark is trying to answer this question using the "Danish Prostate Cancer Registry" (DAPROCAdata). Over the five-year study period, 15,465 test persons answered questions about their quality of life using a validated EPIC-26 questionnaire. The focus was on micturition, urinary and/or fecal incontinence, hormonal symptoms, and sexual function.
Already in the first questionnaire, about one year after the start of the study - and thus simultaneously in the first year after the respective intervention - the quality of life in all symptom domains decreased by about 10 points. After that, the values recovered slightly, but then remained relatively constant until the second survey in the third year after diagnosis.
As expected, of the procedures for prostate cancer therapy, prostatectomy caused the greatest negative impact on the quality of life of the men affected. Restrictions in sexual function and urinary incontinence determined this negative effect.
Generally speaking, sexual function also had the greatest impact on the quality of life in all symptom domains. Irrespective of the treatment modalities, restrictions in sexual function were always felt to be the greatest burden.
People with cancer are increasingly concerned with maintaining a certain level of quality of life in addition to actual survival. However, this has only been receiving increased attention in research in recent years - with an increasing number of studies that focus on the patient, their own feelings about prostate cancer treatment, and the effects on quality of life.
The present work shows that the quality of life falls particularly sharply in the first year after diagnosis and intervention. According to the authors of the study, it is therefore particularly important that clinical interventions for symptoms improvement take place within this first year.
This includes, for example, giving more importance to sexual function and its rehabilitation at an early stage. The topic of penile rehabilitation should be addressed and discussed before the surgery. Early work, e.g. on erectile function, may increase the chances of success. This is because in addition to the primary therapy of prostate cancer, the sexual function has the greatest impact on the quality of life of the men affected.
Source:
Nguyen-Nielsen M et al., Cancer Epidemiology 2020; 64: 101623 https://doi.org/10.1016/j.canep.2019.101623